Concurrent Pulmonary, Intracranial, Intramedullary Tuberculoma, and Their Response to Conservative Management

Abstract

Tuberculomas of the central nervous system are common. However, the incidence of intraspinal intramedullary tuberculomas is very low, and a combination of intramedullary, intracranial, and pulmonary tuberculomas is extremely rare. We report a case of tuberculoma involving the brain and spine with pulmonary tuberculosis in a 46-year-old man initially presenting with back pain and weakness of both lower extremities. Conservative treatment with antituberculous medications resulted in complete resolution of his symptoms.

A newly diagnosed HIV patient with paraplegia: what could be a possible cause?

“…Molecular rapid tests can be done on tuberculoma specimens, but the sensitivity is 79.5% so that in determining extrapulmonary tuberculosis disease and especially in HIV patients, clinical assessment is needed to start empirical therapy until the results of gold standard examination or negative results (TB Care I, 2014). The best modality for the diagnosis of tuberculoma is MRI which can assist clinicians making invasive intervention decisions (Khan et al,2018;Changal & Raina, 2014). Tuberculomas are hypo-isointense lesions in T2-weighted (T1W1) image and low-intensity lesions with or without central hyperintensity (due to wide variations in caseating necrosis) in T2-weighted (T2W1) image.…”

“…Intense ring enhancement appears in post-contrast administration. Differential diagnosis of intramedullary tuberculomas is neurocysticercosis, lymphoma and metastatic tumors (Khan et al, 2018). Thoracal segment of spinal cord is a frequently affected part (Chen et al, 2016;Changal & Raina, 2014).…”